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European Heart Journal. Acute Cardiovascular Care

Alban-Elouen Baruteau, Thomas Barnetche, Luc Morin, Zakaria Jalal, Nicholas S Boscamp, Emmanuel Le Bret, Jean-Benoit Thambo, Julie A Vincent, Alain Fraisse, Alejandro J Torres
BACKGROUND: Transcatheter techniques are emerging for left atrial (LA) decompression under venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aimed to assess whether balloon atrioseptostomy (BAS) is a safe and efficient strategy. METHODS: All patients who underwent percutaneous static BAS under VA-ECMO at four tertiary institutions were retrospectively reviewed. RESULTS: From 2000 to 2014, BAS was performed in 64 patients (32 adults and 32 children)...
October 14, 2016: European Heart Journal. Acute Cardiovascular Care
Alfonso Jurado-Román, Pilar Agudo-Quílez, Belén Rubio-Alonso, Javier Molina, Belén Díaz, Julio García-Tejada, Roberto Martín, Rocío Tello
BACKGROUND: There are few data on the prognostic significance of the wall motion score index compared with left ventricle ejection fraction after an acute myocardial infarction. Our objective was to compare them after the hyperacute phase. METHODS: Transthoracic echocardiograms were performed in 352 consecutive patients with myocardial infarction, after the first 48 hours of admission and before hospital discharge (median 56.3 hours (48.2-83.1)). We evaluated the ability of the wall motion score index and left ventricular ejection fraction to predict the combined endpoint (mortality and rehospitalization for heart failure) as a primary objective and the independent events of the combined endpoint as a secondary objective...
October 13, 2016: European Heart Journal. Acute Cardiovascular Care
Federico Guerra, Lorena Scappini, Alessandro Maolo, Gianluca Campo, Rita Pavasini, Matilda Shkoza, Alessandro Capucci
BACKGROUND: Stroke is a rare but serious complication of acute coronary syndrome. At present, no specific score exists to identify patients at higher risk. The aim of the present study is to test whether each clinical variable included in the CHA2DS2-VASc score retains its predictive value in patients with recent acute coronary syndrome, irrespective of atrial fibrillation. METHODS: The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines...
October 5, 2016: European Heart Journal. Acute Cardiovascular Care
Tetsuma Kawaji, Hiroki Shiomi, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Kenji Ando, Tetsu Mizoguchi, Mitsuru Abe, Mamoru Takahashi, Takeshi Kimura
BACKGROUND: Cardiogenic shock remained the leading cause of death in ST-segment elevation acute myocardial infarction (STEMI) patients even in the primary percutaneous coronary intervention era. METHODS: Among 3942 STEMI patients with primary percutaneous coronary intervention within 24 h after symptom-onset in the Coronary Revascularization Demonstrating Outcome Study in Kyoto acute myocardial infarction registry, the study population of the current analysis consisted of 466 STEMI patients who were complicated by cardiogenic shock due to acute pump failure...
October 5, 2016: European Heart Journal. Acute Cardiovascular Care
Magnus T Jensen, Marta Pereira, Carla Araujo, Anti Malmivaara, Jean Ferrieres, Irene R Degano, Inge Kirchberger, Dimitrios Farmakis, Pascal Garel, Marina Torre, Jaume Marrugat, Ana Azevedo
AIMS: The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain)...
September 30, 2016: European Heart Journal. Acute Cardiovascular Care
Patrick Sulzgruber, Fritz Sterz, Michael Poppe, Andreas Schober, Elisabeth Lobmeyr, Philip Datler, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Pia Hubner, Peter Stratil, Christian Wallmueller, Christoph Weiser, Alexandra-Maria Warenits, Raphael van Tulder, Andreas Zajicek, Angelika Buchinger, Christoph Testori
BACKGROUND: While prognostic values on survival after out-of-hospital cardiac arrest have been well investigated, less attention has been paid to their age-specific relevance. Therefore, we aimed to identify suitable age-specific early prognostication in elderly patients suffering out-of-hospital cardiac arrest in order to reduce the burden of unnecessary treatment and harm. METHODS: In a prospective population-based observational trial on individuals suffering out-of-hospital cardiac arrest, a total of 2223 patients receiving resuscitation attempts by the local emergency medical service in Vienna, Austria, were enrolled...
September 26, 2016: European Heart Journal. Acute Cardiovascular Care
Michael J Daly, Dewar D Finlay, Daniel Guldenring, Raymond R Bond, Aaron J McCann, Peter J Scott, Jennifer A Adgey, Mark T Harbinson
INTRODUCTION: Epicardial potentials (EPs) derived from the body surface potential map (BSPM) improve acute myocardial infarction (AMI) diagnosis. In this study, we compared EPs derived from the 80-lead BSPM using a standard thoracic volume conductor model (TVCM) with those derived using a patient-specific torso model (PSTM) based on body mass index (BMI). METHODS: Consecutive patients presenting to both the emergency department and pre-hospital coronary care unit between August 2009 and August 2011 with acute ischaemic-type chest pain at rest were enrolled...
September 26, 2016: European Heart Journal. Acute Cardiovascular Care
Uwe Zeymer, Karl Werdan, Gerhard Schuler, Ralf Zahn, Franz-Josef Neumann, Georg Fürnau, Suzanne de Waha, Steffen Schneider, Holger Thiele
BACKGROUND: Current guidelines recommend immediate multivessel percutaneous coronary intervention (PCI) in patients with cardiogenic shock, despite the lack of randomised trials. We sought to investigate the use and impact on outcome of multivessel PCI in comparison to culprit lesion only PCI in a retrospective analysis in patients with cardiogenic shock complicating acute myocardial infarction. METHODS AND RESULTS: In the randomised IABP-SHOCK II trial, investigating the effect of intra-aortic balloon pump on outcome, 451 (75%) of the total of 600 patients had multivessel coronary artery disease and underwent PCI...
September 21, 2016: European Heart Journal. Acute Cardiovascular Care
Thorarinn A Bjarnason, Linda B Kristinsdottir, Erna S Oskarsdottir, Steinar O Hafthorsson, Isleifur Olafsson, Sigrun H Lund, Karl Andersen
BACKGROUND: Previously undetected dysglycaemia is common among patients with acute coronary syndromes (ACSs). The aim of this study was to identify the most reliable method of diagnosing type 2 diabetes mellitus (T2DM) and prediabetes in ACS patients. METHODS: Patients admitted to the coronary care unit with ACSs and no previous history of T2DM were consecutively included in the study. Glucose metabolism was measured by glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) with a standard oral glucose tolerance test during hospital admission, and this process was repeated 3 months later...
September 13, 2016: European Heart Journal. Acute Cardiovascular Care
Francois Schiele, Chris P Gale, Eric Bonnefoy, Frederic Capuano, Marc J Claeys, Nicolas Danchin, Keith Aa Fox, Kurt Huber, Zaza Iakobishvili, Maddalena Lettino, Tom Quinn, Maria Rubini Gimenez, Hans E Bøtker, Eva Swahn, Adam Timmis, Marco Tubaro, Christiaan Vrints, David Walker, Doron Zahger, Uwe Zeymer, Hector Bueno
Evaluation of quality of care is an integral part of modern healthcare, and has become an indispensable tool for health authorities, the public, the press and patients. However, measuring quality of care is difficult, because it is a multifactorial and multidimensional concept that cannot be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial infarction (AMI), but no such indicators exist in Europe...
August 29, 2016: European Heart Journal. Acute Cardiovascular Care
Jianhua Wu, Chris P Gale, Marlous Hall, Tatendashe B Dondo, Elizabeth Metcalfe, Ged Oliver, Phil D Batin, Harry Hemingway, Adam Timmis, Robert M West
AIMS: Early and accurate diagnosis of acute myocardial infarction is central to successful treatment and improved outcomes. We aimed to investigate the impact of the initial hospital diagnosis on mortality for patients with acute myocardial infarction. METHODS AND RESULTS: Cohort study using data from the Myocardial Ischaemia National Audit Project of patients discharged with a final diagnosis of ST-elevation myocardial infarction (STEMI, n=221,635) and non-STEMI (NSTEMI, n=342,777) between 1 April 2004 and 31 March 2013 in all acute hospitals (n = 243) in England and Wales...
August 29, 2016: European Heart Journal. Acute Cardiovascular Care
Emily M Bucholz, Kelly M Strait, Rachel P Dreyer, Stacy T Lindau, Gail D'Onofrio, Mary Geda, Erica S Spatz, John F Beltrame, Judith H Lichtman, Nancy P Lorenze, Hector Bueno, Harlan M Krumholz
AIMS: Young women with acute myocardial infarction (AMI) have a higher risk of adverse outcomes than men. However, it is unclear how young women with AMI are different from young men across a spectrum of characteristics. We sought to compare young women and men at the time of AMI on six domains of demographic and clinical factors in order to determine whether they have distinct profiles. METHODS AND RESULTS: Using data from Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO), a prospective cohort study of women and men aged ⩽55 years hospitalized for AMI (n = 3501) in the United States and Spain, we evaluated sex differences in demographics, healthcare access, cardiovascular risk and psychosocial factors, symptoms and pre-hospital delay, clinical presentation, and hospital management for AMI...
August 2, 2016: European Heart Journal. Acute Cardiovascular Care
Sergio Leonardi, Renato D Lopes, Ph Gabriel Steg, Freddy Abnousi, Alberto Menozzi, Jayne Prats, Stacey Mangum, Matthew Wilson, Meredith Todd, Gregg W Stone, C Michael Gibson, Christian W Hamm, Matthew J Price, Harvey D White, Robert A Harrington, Deepak L Bhatt, Kenneth W Mahaffey
AIMS: The purpose of this study was to test whether different results between Cangrelor versus standard therapy to acHieve optimal Management of Platelet InhibitiON (CHAMPION) PCI/PLATFORM and PHOENIX trials are due in part to different definitions of percutaneous coronary intervention (PCI)-related myocardial infarction (MI). METHODS AND RESULTS: In patients with acute coronary syndrome (ACS), the definition of MI was identical in CHAMPION PCI and PLATFORM and did not require an assessment of baseline cardiac biomarker status, while in PHOENIX specific MI criteria were associated with different patient presentations...
August 2, 2016: European Heart Journal. Acute Cardiovascular Care
Thomas Stiermaier, Charlotte Eitel, Steffen Desch, Georg Fuernau, Gerhard Schuler, Holger Thiele, Ingo Eitel
BACKGROUND: Takotsubo cardiomyopathy (TTC) can be accompanied by various life-threatening complications, including cardiogenic shock. The exact incidence and prognostic relevance of cardiogenic shock in TTC patients has not been studied in detail. METHODS: The frequency and determinants of cardiogenic shock were evaluated in 178 patients with TTC. The clinical course and treatment strategies of TTC patients with cardiogenic shock were systematically analysed. Furthermore, short and long-term mortality rates were assessed with a structured telephone follow-up...
October 2016: European Heart Journal. Acute Cardiovascular Care
Céline Haas, Stephane Fournier, Juan-Fernando Iglesias, Catalina Trana, Christan Roguelov, Didier Locca, Nathalie Lauriers, Olivier Muller, Eric Eeckhout
AIMS: The present study aimed to document a local pattern of care in consecutive patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) in a tertiary centre in Switzerland. METHODS: A retrospective study was conducted at the University Hospital of Lausanne, Switzerland. A total of 389 consecutive patients undergoing primary percutaneous coronary intervention for STEMI between 2009 and 2010 were studied. The audit focused on 14 items derived from the American College of Cardiology/American Heart Association 2008 quality performance measures position paper on STEMI management...
October 2016: European Heart Journal. Acute Cardiovascular Care
Nils A Sörensen, Anoop Sv Shah, Francisco M Ojeda, Philipp Peitsmeyer, Tanja Zeller, Till Keller, Silke S Johannsen, Karl J Lackner, Megan Griffiths, Thomas Münzel, Nicholas L Mills, Stefan Blankenberg, Renate B Schnabel
AIMS: To evaluate the diagnostic performance of high-sensitivity troponin I (hsTnI) and other novel biomarkers for diagnosing non-ST-segment elevation myocardial infarction (NSTEMI) in patients with atrial fibrillation. METHODS: In an acute chest pain cohort (N=1673), mean age 61.4±13.6 (34% female), we measured hsTnI and 13 established and novel biomarkers reflecting ischaemia, necrosis, inflammation, myocardial stress, angiogenesis on admission and after three hours in order to investigate their diagnostic accuracy for NSTEMI...
October 2016: European Heart Journal. Acute Cardiovascular Care
Gianluca Campo, Mila Menozzi, Paolo Guastaroba, Luigi Vignali, Laura Mb Belotti, Gianni Casella, Elena Berti, Emilia Solinas, Vincenzo Guiducci, Simone Biscaglia, Rita Pavasini, Rossana De Palma, Antonio Manari
BACKGROUND: The service strategy (same-day transfer between spoke hospital and hub centre with catheterisation laboratory (cath-lab) facility to perform invasive procedures) has been suggested to improve the management of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) admitted to spoke hospitals. We used data from a large prospective Italian registry to describe application, performance and outcome of the service strategy in the daily clinical practice. METHODS: This study was based on an observational, post-hoc analysis of all consecutive NSTEACS patients admitted to spoke non-invasive hospitals of the Emilia-Romagna regional network and receiving coronary artery angiography (CAA)±percutaneous coronary intervention (PCI)...
October 2016: European Heart Journal. Acute Cardiovascular Care
Moritz Biener, Evangelos Giannitsis, Judith Lamerz, Matthias Mueller-Hennessen, Mehrshad Vafaie, Hugo A Katus
AIMS: To investigate the prognostic implications of elevated high-sensitivity cardiac troponin T (hs-cTnT) values in presumably stable ambulatory coronary artery disease patients. METHODS AND RESULTS: We conducted a retrospective, single-centre pilot observational study in a low-risk population. All patients received routine measurement of hs-cTnT at index and follow-up visits. Endpoints were all-cause mortality and a composite of all-cause mortality, acute myocardial infarction, stroke and rehospitalization for acute coronary syndrome and heart failure...
October 2016: European Heart Journal. Acute Cardiovascular Care
Anna Holm, Sofia Sederholm Lawesson, Eva Swahn, Joakim Alfredsson
BACKGROUND: Bleeding complications increase mortality in myocardial infarction patients. Potential gender difference in bleeding regarding prevalence and prognostic impact is still controversial. OBJECTIVES: Gender comparison regarding incidence and prognostic impact of bleeding in patients hospitalised with myocardial infarction during 2006-2008. METHODS: Observational study from the SWEDEHEART register. Outcomes were in-hospital bleedings, in-hospital mortality and one-year mortality in hospital survivors...
October 2016: European Heart Journal. Acute Cardiovascular Care
Toru Suzuki, Alexander Lyon, Rajeev Saggar, Liam M Heaney, Kenichi Aizawa, Antonio Cittadini, Ciro Mauro, Rodolfo Citro, Giuseppe Limongelli, Francesco Ferrara, Olga Vriz, Andrew Morley-Smith, Paolo Calabrò, Eduardo Bossone
Acute cardiothoracic and respiratory diseases frequently remain a challenge to diagnose and differentiate in the emergency setting. The main diseases that manifest with chest pain include ischaemic heart disease, myocarditis, acute pericarditis, aortic dissection/rupture and pulmonary embolism (PE). Diseases that primarily present with dyspnoea include heart failure (HF), acute respiratory distress syndrome (ARDS), pneumonia, asthma exacerbations and chronic obstructive pulmonary disease. Pre-test probabilities of clinical findings play a vital part in diagnostic decisions, and the use of a Bayesian approach to these greatly improves the ability to stratify patients more accurately...
September 2016: European Heart Journal. Acute Cardiovascular Care
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